Read March text version

Medical Staff Update, March 2010

Special points of interest:

· Medical Staff ID Badges · Recycling Program Kick Off

Medical Staff ID Badges Are Going Green!

Green backgrounds that is! In order to meet a future JCAHO requirement we wanted to create a way for patients to easily identify when a physician was providing healthcare services for them. You may have already noticed when walking our hallways the different color name badges that others are wearing. For instance a Memorial employee has a blue background to their badges while volunteers have an orange background. If one of your employees provides care at Memorial Hospital as an Allied Health Professional their background would be purple, to name a few. In the coming weeks the Medical Staff Office will be making contact with you or your office staff to "trade-out" your picture ID. You can also stop in the Medical Staff office as well, whichever works easiest for you. Restricted Parking Update Memorial has received comments on the unavailability of parking spots in the Physician parking areas within the parking garages. In order to assist with this, the Medical Staff Office is distributing "parking tags" to hang from the rearview mirrors of your vehicles. Please be sure to place the "tags" within easy viewing. By doing so our Security may begin to weed out those vehicles that will need to moved to unrestricted areas within the garage.

Inside this issue: A Byte of IT...

Screen Saver Lock/ Password Unlock

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Password Complexity Requirement Medical Records Coding Note: From the Pharmacy Department Anticoagulation Clinic

CME Opportunities

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In Special Remembrance... Please Provide Your Input!

Recycling Program Kick Off!

Planet Health is excited to introduce its new recycling program at the Hospital campus. A green trash hauler has been placed near the "B" elevators in the basement of the Hospital, so all you have to do is toss in your bagged items. This single stream recycling process means that sorting and separating materials is unnecessary. Just consult the list of acceptable items outside the bins. Also, since all confidential information needs to be placed in the EnviroShred bins anyway, we encourage you to dispose of all paper through EnviroShred in order to prevent any confusion. Within the next week, large blue recycling bins will also be placed in non-public areas (often in soiled linen closets) around the campus to increase convenience. These areas will be identifiable by the nearby Planet Health recycling logo. This new program has been made possible by our Environmental Services Team, but many departments have accepted the additional responsibility of maintaining one of these bins. Planet Health thanks all Team Members for doing their part and making this new program a success. For questions about Planet Health, contact [email protected]

Welcome New Medical 4 Staff Members

Contact Info Medical Staff Leadership

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Medical Staff Update,

A Byte of IT ...

From Your CMIO, Dr. Ken Elek

It's been almost 3-months now that I've been the Chief Medical Information Officer at Memorial and I can tell you the learning curve is very steep. I've been working on finding things that will improve our work lives both in and out of the hospital when it comes to having access to critical information for patient care. In the near future I am planning on having the ability to access PACS web from the links tab at the top when you are in the patient chart in PowerChart. You will still have to re-enter your login information since you're opening a new program that's not directly connected to PowerChart. It's the best I can offer for now but will keep working on finding ways to make it easier to access what we need. I will also be working on what part of the chart opens initially and would like as much feedback as I can get. Personally, opening to the 48-hour results doesn't work well for me and I would guess others feel the same. I would also like feedback on how you use your patient lists and whether they are set up in a way that shows you the patients you want to see on them. I've played with these lists a lot over the years and still don't find them the easiest to set up. Once they're set up, however, they work great. I have been working on getting Mpages set up. Mpages are a way of pulling selected information out of the patient's record and putting that information all in one place. Right now we have a very limited version but once our programmers learn how to make them they will be more powerful. The two we have are called the ED Summary and the Inpatient Summary. I think you will like them once they work to my satisfaction. We're really close but not quite there yet. I will plan on sending information like this out twice a month so the information is up-to-date and the reading of it manageable. Please send me your feedback either by email at [email protected] or telephone at 574-647-3070. I'm here to serve you in doing whatever I can to make our workflows optimal and I'm working with a team that has those same goals in mind. Thanks!

Password Complexity Requirement Change Effective 4/14/10 :

Memorial's network password requirements are being strengthened to protect your identity and our patient's medical identity. To continually maintain HIPAA requirements for Memorial's systems and data, the password requirements for accessing the network will change to require a password of: · Minimum of 8 characters · At least 1 lowercase alpha · At least 1 uppercase alpha · At least 1 numeric · No username in password You do not have to do anything for this change except the next time your password expires your new password must meet the requirements above.

Screen Saver Lock/Password Unlock Policy Removed by 3/29/10:

The screen saver lock/unlock password on all the clinical computer logging in with generic user names (for example 10sz1a, cbuz2a, etc) will be removed. This means that you will no longer have to unlock the screen with a Ctrl-Alt-Del and enter the password. The screen saver timeout itself MUST remain at the designated time out per our Memorial policy: - 10 minutes Clinical, public areas - 30 minutes Non-clinical, non-public areas - 60 minutes Critical work completion areas


Just like any predator, computer hackers prey on easy targets. In an instant computer hackers can steal your ID, your financial information, personal documents, and anything else that you put onto a computer. These same hackers are also looking for corporate information and, in Memorial's case, patient data too.

Important Password Information:

1) 2) DON'T give your password to anyone especially when asked in an email. YOU SHOULD use passwords that you can recall without having to write them down ­ i.e. use the first initials of a favorite phrase.

3) DON'T use personal information like your birthday, pets names, kids names, your department name, job title, dictionary words, etc. These are things that hackers would guess that you used because they are so easy for you to remember. (Dictionary words are notorious with hackers and there is hacking software available on the internet to use dictionary words to run password cracking attempts.)

March 2010

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From the Medical Records Department...

Coding Note: What is it and why is it necessary? A "Coding Note" is a question to the physician to clarify documentation in the medical record to assure proper reporting of the conditions and/or procedures that occurred during a patient's stay. To avoid papers being faxed back and forth between the Medical Record Department and the physician's office, an electronic version in Power Chart of this clarifying function has been created with the ability for the physician to answer the question while completing his or her medical records. Okay, now why is it necessary? It's necessary for a variety of reasons. The most common scenario is for pathology confirmation on patients who have been discharged prior to the pathology report being available to the physician. Unfortunately, official reporting guidelines prohibit the pathologic diagnosis from being reported unless the attending physician confirms it. Without the physician's confirmation, the condition cannot be reported. This has the downstream effects of inaccurate data for studies of patient populations, inaccurate registries, inaccurate severity of illness and risk of mortality rating, as well as reimbursement implications (to name a few). These Coding Notes are now able to be answered while the physician is completing his or her medical records. The physician is now able to respond to the query, through the Inbox function, making his or her response a permanent part of the medical record. Because your response will require more than simply signing the note, instructions with screen-shots of this process will be mailed to your offices soon. These instructions will also include a phone number for you to call should you run into any difficulties with the instructions and/or completing the process.

From the Pharmacy Department...


In an effort to comply with The Joint Commission's National Patient Safety Goal 3E ­ Reduce the likelihood of patient harm associated with the use of anticoagulation therapy, Memorial is requiring initial warfarin orders to contain an indication and goal INR range. There are warfarin physician order sets available on the patient care areas that include all the necessary requirements. A go-live date of April 5th, has been set, after which time, physicians will be called for clarification if an indication and goal range has not been documented Over the past year, we have identified a significant number of ADRs and supratherapeutic INRs in patients receiving 10mg or greater loading doses. The Memorial Anticoagulation with Warfarin Policy recommends a starting dose of 5mg for most patients (2.5mg in high risk patients). Reminder ­ The Pharmacy department is available to dose warfarin for your patients admitted to the hospital ­ just write "Warfarin pharmacy to dose" and specify an indication and goal INR range. In addition, the Memorial Outpatient Anticoagulation Clinic is accepting referrals for outpatient management of patients on warfarin. Please call 574-647-3127 for further details.

Protonix: IV to PO Interchange

The P&T Committee has approved the interchange of IV to PO pantoprazole (Protonix) in patients taking other PO meds. Pharmacy will automatically switch patients to PO pantoprazole when they are on other PO meds. Patients will be excluded if they are on a continuous infusion of Protonix or if they have an NG tube.


Beginning April 5th, piperacillin/tazobactam (Zosyn) will be given as an extended infusion over 4 hours. As approved by P&T and Infection Control committees, pharmacy will convert orders for Zosyn to this extended infusion time. The rational for extended infusion Zosyn is as follows: 1) Extended infusion over 4 hours provides greater efficacy by increasing Time above MIC. 2) Extended infusion uses less drug and thereby decreases cost. Hemodialysis patients and pediatrics are excluded. If you should have any questions, please contact Gary Hudson, RPH, at 574-647-3119

When discharging a patient on Lovenox, please write a prescription and round doses to the nearest 10mg. This is the rounding policy that is used at Memorial. This may save you a phone call from a nurse or pharmacist for an order or clarification.

Lovenox Doses for Patients being Discharged

March 2010

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Please Provide Your Input!

Help us get a comprehensive picture of the patterns and demand in regards to cognitive health services in our community. If you haven't already taken a moment to help us summarize the quantity and patterns of inquiries about cognitive health issues, please take a minute now to respond. Go to s/625LJKR and complete the 10 questions.

CME Opportunities:

Held 12:10--1:15pm in the Auditorium at MHSB April 7th-Steve Huffman, VP, CIO, "The $44,000 Question??? Practical Guidance in a Fluid Area" April 14th-Mohamed Farhat, MD "Colon Cancer Update" April 28th­ Medhat M. Osman, MD, ScM, PhD: "PET Scanning in the Community: Indicators for a Mysterious Test" Please call 574-647-7381 for more information and CME opportunities.

Medical Staff Officers President Thomas Hauch, M.D. Vice President Etta Nevel, M.D. Secretary-Treasurer John Mathis, M.D.

Thank you!!

Medical Staff Office Cheryl A. Wibbens, M.D. Pamela Hall, CMSC, CPCS

Physician Liaison-Administration Medical Staff Coordinator Vice President Medical Affairs

Tawnn Hoover

Executive Assistant

Mariellan Weaver

Phone: 574-647-7920 Fax: 574-647-6691

E-mail: [email protected]

Please send any information you would like to see included in future newsletters to Mariellan Weaver, [email protected] or contact her at 574-647-7920 You may view current and previous Medical Staff Updates at hospital/newsletter.cfm

Specialty Dates on Staff Kristen E. Allen, M.D. Obstetrics & Gynecology 05/26/2005--02/09/2009 James E. Hoffman, M.D. Internal Medicine 08/29/2002--04/22/2009 William H. Shriber, M.D. Obstetrics & Gynecology 02/20/1963--04/26/2009 Philip J. Gabriele, M.D. Ophthalmology 08/19/1999--06/15/2009 Juan C. Garcia, M.D. Oncology/Hematology 07/01/1976--08/11/2009 Rafael Macias, M.D. Surgery 10/04/1965--11/28/2009 Harry Stimson, M.D. Family Medicine 01/01/1971--03/21/2010 Where are the dreamers and the risk takers, who, when in their youth, were called and cared, for others, in their time of need? Care extended, care received. A cause, a relationship, formed of knowledge, Armed with desire, entered into a noble, and blessed tradition. A tradition which placed others before self, a tradition to heal and do no harm. We ask...where are the dreamers and risk takers now? They are here beside you, side-by-side. Written by Dean Strycker, M.D.

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Welcome New Medical Staff Members:

Florentino A, Aquino, MD General Surgery, Affiliate Membership

Main Street Medical Group 6913 N. Main Street Granger, IN 46530

Rachelina P. Kvietkus, MD Internal Medicine, Affiliate Membership

Bendix Family Physicians 1010 N. Bendix Drive South Bend, IN 46628

Richard A. Federspiel, MD Dermatology, Affiliate Membership

720 E. Cedar Street, Suite 280 South Bend, IN 46617

Bridget Merritt-Brooks, DDS General Dentistry

Small Smiles Dental Center of SB 2332 Miracle Lane Mishawaka, IN 46545

Gregory C. Gifford, MD Palliative Medicine The Center for Hospice & Palliative Care

111 Sunnybrook Ct. South Bend, IN 46637

Linus A. Ngante, MD Family Medicine,Affiliate Membership

Bendix Family Physicians 1010 N. Bendix Drive South Bend, IN 46628

Mary H. Griffin, MD Pediatrics, Affiliate Membership

Memorial Neighborhood Center--SE 1708 South High Street South Bend, IN 46613

Andrey P. Seluzhitskiy, MD Family Medicine

South Bend Clinic at New Carlisle 8984 East US Highway 20 New Carlisle, IN 46552



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